John Bielinski’s Talk EM - Enhancing Clinical Excellence in EM

In this episode of TalkEM leading experts in emergency medicine discuss risk factors, clinical indicators, and treatment interventions for pulmonary embolisms. Listen as Dr. Joshua Lynch, Dr. John McNamara, and John Bielsinki PA-C reflect on their experiences assessing and treating high risk patients in emergency room and primary care settings. 

In any patient that presents with chest pain or pulmonary symptoms you need to defend your chart against a missed PE. The best defense starts with a great offense.  In this episode of TalkEM we explore presenting signs and symptoms that raise suspicion of a pulmonary embolism. As well as diagnostic test to confirm a suspected diagnosis and the best clinical practices for assessment and documentation. Your clinical assessment and documentation must CYA.

Application is key. If you have been listening to TalkEM, you have been learning tools to assist you in clinical practice. In this episode of TalkEM we present a case study to illustrate the clinical applications of two of the clinical tools introduced during earlier episodes, the PAPPA and HORID mnemonics. 

In part four of our four-part series on chest pain, featured speaker John Bielinski explores EKG interpretation. Due to the complexity of EKG interpretation this topic it is difficult to capture and almost impossible to teach during a brief podcast session. However, John effectively utilizes his time by providing strategies clinicians may utilize to advance their knowledge and understanding of EKG interpretation. John also introduces multiple mnemonic devices to assist with EKG interpretation.

In part three of our four-part series on chest pain, featured speaker John Bielinski explores the role of laboratory medicine in the assessment of chest pain. John addresses the difficult questions about laboratory medicine and chest pain. How do you look at your labs in assessing chest pain?  The troponin? The CK?  Myoglobin? How about other chest pain markers, like the WBC, or ESR or BNP or D-Dimer?  This episode provides clinical answers. 

In part two of our four-part series on chest pain, featured speaker John Bielinski introduces a risk assessment procedure for patients presenting with chest pain. John identifies the key components of assessment as “Pipes, Psych & Story.” John also introduces the mnemonic DRiVE to obtain a detailed history as part of assessment procedures.

Don't be afraid to be wrong.  It's that simple. Too often providers get a good subjective and objective exam, yet fall short on assessment and plan. In this installment of TalkEM featured speaker John Bielinski addresses one of the biggest challenges new clinicians face when transitioning into practice, which is fear.  John explores how fear stifles critical thinking and decision making.  John empowers clinicians to overcome their fears and take initiative when assessing and developing treatment plans

In part 1 of our four-part series on chest pain, featured speaker John Bielinski discusses cognitive bias and the implications for emergency medicine professionals. John empowers listeners to explore and identify their strengths and weakness when it comes to assessing chest pain. Intuition is fostered through education, repetitious exposure, and critical case analysis. Training plans may be tailored to meet individual needs once strengths and weaknesses are identified. 

Chest pain can be catastrophic. In emergency medicine or in any acute setting there are five causes of chest pain that needs to be considered.      Pericarditis      ACS      PE      Pneumothorax      Thoracic aneurysm In this installment of TalkEM featured speaker John Bielinski explores the differential diagnosis of chest pain with a useful mnemonic. 

It's critically important as an APP to have the courage to ask for what you need.  If you need a physician to see a patient - you need to lead with that.  It's called an AP-SOAP note.  AP = your assessment and plan.  It sounds something like this, "doc, I have a patient I am uncomfortable with (your assessment) and I would like you to come see them with me (your plan.)  Too often APPs don't ask for what they need and the patient suffers. 

During this episode of TalkEM John Bielinski interviews Michelle Mullaney, a Physician Assistant that specializes in Primary Care Medicine. John reflects on his experiences working in an Urgent Care setting as Michelle explores a possible career transition from Primary Care. Throughout discussion John shares insights about acute care and tips for practicing medical professionals considering a similar career transition.

In the first installment of our Emergency Medicine Institute podcast series, Dr. David Pierce reflects on his experiences working in the Emergency Department. Dr. David Pierce’s candor and revelations provide an insightful, compelling illustration of the challenges one faces when it comes to engaging patients within the time constraints of the Emergency Department.